Individual
AMANDA DIENNO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
875 PERIMETER DR # MS 2401, MOSCOW, ID 83844-9803
(208) 855-2182
Mailing address
640 SW GOLDEN HILLS DR APT A201, PULLMAN, WA 99163-6709
(253) 549-5877
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
06/02/2017
Last updated
06/02/2017
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